How does alcohol abuse affect diabetes?

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William Lee Dubois
Endocrinology Diabetes & Metabolism

Going out on a limb here, I’m guessing that you are asking about a loved one, as few heavy drinkers would classify themselves as alcohol abusers.

But the bottom line is that diabetes and true alcohol abuse do not play well together.

There’s a reason I said “true,” because there’s quite a range of real and perceived alcohol abuse. I’ve had wives in my office claiming that their husbands abuse alcohol when in fact the poor guy just has a couple of beers on the weekend. Other times I’ve had patients look me straight in the eye and tell me that they can down a thirty pack a day with “no problem.” (I honestly had no idea that 30-packs even existed before the first time I had that conversation.)

But for the purposes of this answer, we’ll assume that the person with diabetes really does abuse booze. First and foremost, alcohol abuse is really hard on the liver. The liver, the largest organ in your body other than your skin, is a multi-tasking organ. It stores sugar, makes digestive juices, and serves as a filter to remove assorted toxins from your blood. Alcohol being one of those toxins. But a great many diabetes medications are also “cleared” by your liver. So taking diabetes meds and abusing alcohol together can over tax your liver. Maybe over tax is too subtle. It could lead to liver failure. And death.

Everybody clear on that?

So death would be a real problem. Another booze and diabetes problem that can also kill you is that alcohol can cause low blood sugar. If you are taking medications to lower high blood sugars and add alcohol to the mix than you can go really, really low. And that can be really, really bad. These lows often happen downstream, when the drinker is sleeping it off. That’s bad because if a severe low blood sugar hits when you are in a deep sleep you may not feel it. It may not wake you up. You may not wake up ever.

And the last effect we have room for today is the fact than many kinds of alcohol also have calories. If you drink waaaaaaaay too much you will get fat or fatter. Extra weight makes insulin resistance worse and can make diabetes harder to control.

If you have diabetes and your blood glucose levels are on target, it is generally safe to drink alcohol occasionally. However you may have an alcohol abuse problem if you drink too much or have trouble controlling how much alcohol you drink.

Alcohol abuse is even more dangerous for people with diabetes. Many diabetes complications—including nerve damage, eye problems, high blood pressure, kidney disease, and heart disease—can worsen with excessive alcohol use. Long-term alcohol abuse can interfere with how you take care of your diabetes.

Alcoholism and the Liver

Alcohol abuse is especially hard on the liver, where your body stores glucose. If your liver is damaged by alcohol, your blood glucose levels may become erratic, and you are more likely to have hypoglycemia.

Ending alcohol abuse can be very difficult, but it is crucial for many reasons, including your diabetes care. If you have a problem with alcohol, or think you might have a problem, there is help available to you. Talk to your pro­vider, or call your local chapter of Alcoholics Anonymous (AA). Your health care team can help you find the treatment you need to begin the path to recovery.

Continue Learning about Alcoholism

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.